X-Message-Number: 24830 Date: Sat, 16 Oct 2004 10:02:09 -0700 (PDT) From: Doug Skrecky <> Subject: walnuts and exercise versus endothelial aging Med Hypotheses. 2004;63(4):719-23. Optimizing endothelial nitric oxide activity may slow endothelial aging. The capacity of vascular endothelium to generate bioactive nitric oxide (NO) decreases with advancing age, even in healthy subjects with a relatively benign risk factor profile; this phenomenon may reflect decreased expression of NO synthase, as well as increased production of superoxide, and evidently contributes importantly to the increased vascular risk associated with aging. Studies with cultured endothelial cells suggest that the rate of endothelial aging is determined primarily by the rate of cell turnover and the associated progressive shortening of telomeres; endothelial cells transfected with the catalytic subunit of telomerase--which preserves a youthful telomere length--do not show a reduction in NO synthase expression after numerous doublings, in contrast to the marked reduction observed in control cells. Also consistent with this view is the fact that, following balloon denudation of arteries, the regenerated endothelium makes less NO. In the vasculature of adults, the rate of endothelial cell mitosis is evidently a reflection of the rate of endothelial cell apoptosis. Numerous cell culture studies demonstrate that physiological levels of NO protect endothelial cells from apoptosis induced by a wide range of noxious stimuli--including vascular risk factors such as oxidized LDL, angiotensin II, and hyperglycemia. In the human vasculature, endothelial cells with disproportionately short telomeres are found capping atheromatous lesions and in atheroma-prone areas where blood flow is turbulent; these findings evidently reflect increased endothelial cell turnover in regions where NO bioactivity is relatively weak. It can be deduced that lifelong adherence to an "endotheliophilic lifestyle" that optimizes vascular NO production, while minimizing that of superoxide, will literally slow the rate of aging of vascular endothelium, such that, at any given advanced age, the optimal functional capacity of the vascular endothelium will be superior to that of age-matched controls. These considerations underline the desirability of actively promoting vascular health in younger and middle-aged individuals in whom risk for vascular events may still be quite low. The impact of lifelong caloric restriction on endothelial aging requires further study, preferably in primates. Circulation. 2004 Apr 6;109(13):1609-14. Epub 2004 Mar 22 A walnut diet improves endothelial function in hypercholesterolemic subjects: a randomized crossover trial. BACKGROUND: Epidemiological studies suggest that nut intake decreases coronary artery disease (CAD) risk. Nuts have a cholesterol-lowering effect that partly explains this benefit. Endothelial dysfunction is associated with CAD and its risk factors and is reversed by antioxidants and marine n-3 fatty acids. Walnuts are a rich source of both antioxidants and alpha-linolenic acid, a plant n-3 fatty acid. METHODS AND RESULTS: To test the hypothesis that walnut intake will reverse endothelial dysfunction, we randomized in a crossover design 21 hypercholesterolemic men and women to a cholesterol-lowering Mediterranean diet and a diet of similar energy and fat content in which walnuts replaced approximately 32% of the energy from monounsaturated fat. Participants followed each diet for 4 weeks. After each intervention, we obtained fasting blood and performed ultrasound measurements of brachial artery vasomotor function. Eighteen subjects completing the protocol had suitable ultrasound studies. Compared with the Mediterranean diet, the walnut diet improved endothelium-dependent vasodilation and reduced levels of vascular cell adhesion molecule-1 (P<0.05 for both). Endothelium-independent vasodilation and levels of intercellular adhesion molecule-1, C-reactive protein, homocysteine, and oxidation biomarkers were similar after each diet. The walnut diet significantly reduced total cholesterol (-4.4+/-7.4%) and LDL cholesterol (-6.4+/-10.0%) (P<0.05 for both). Cholesterol reductions correlated with increases of both dietary alpha-linolenic acid and LDL gamma-tocopherol content, and changes of endothelium-dependent vasodilation correlated with those of cholesterol-to-HDL ratios (P<0.05 for all). CONCLUSIONS: Substituting walnuts for monounsaturated fat in a Mediterranean diet improves endothelium-dependent vasodilation in hypercholesterolemic subjects. This finding might explain the cardioprotective effect of nut intake beyond cholesterol lowering. Clin Sci (Lond). 2004 Mar;106(3):329-35. Effects of age and physical fitness on microcirculatory function. Sedentary aging is associated with endothelial dysfunction and nitric oxide (NO) impairment. The aim of the present study was to assess the effects of regular physical exercise on nitrite/nitrate (NOx) concentrations and microcirculatory function in older men compared with young individuals. We measured NOx plasma concentrations and baseline and stimulated skin blood flow (SBF) by laser Doppler flowmetry in 39 male athletes [range, 22-72 years; maximal oxygen consumption (VO2max), 60.0 +/- 4.7 ml.min(-1).kg of body weight(-1) (mean +/- S.D.)] and 45 age- and sex-matched sedentary controls (VO2max, 38.0 +/- 7.1 ml.min(-1).kg of body weight(-1)). NOx concentrations were higher in athletes than in controls (50.4 +/- 16.3 compared with 39.0 +/- 15.4 micromol/l; P<0.005), whereas baseline SBF was comparable. Hand SBF after heating and ischaemia and foot SBF after heating were higher in athletes (P<0.0001) than in controls. By comparing the lowest and the highest tertile of age, sedentary young subjects had higher NOx concentrations than sedentary older subjects (43.3 +/- 13.4 compared with 31.8 +/- 12.2 micromol/l respectively; P<0.05). Exercise abolished this difference (49.1 +/- 9.6 micromol/l for young subjects and 52.1 +/- 11.5 micromol/l for older subjects; not significant). Resting SBF was similar in all the subgroups, but stimulated SBFs were lower in both subgroups of untrained compared with trained subjects. NOx concentrations were positively correlated with VO2max (r=0.46, P<0.001). Stimulated SBFs were correlated with NOx (r>0.30, P<0.05). These findings show that chronic exercise may improve endothelial function in older (and young) men, probably by increasing NO availability. Rate This Message: http://www.cryonet.org/cgi-bin/rate.cgi?msg=24830